Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma.

Autor:	Smits J; Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands; GROW - School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands., Chau S; Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands., James S; Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands; GROW - School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands., Korenblik R; Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands; GROW - School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands., Tschögl M; Department of Surgery, HPB Centre Vienna Health Network, Clinic Favoriten, Wienerbergstraße 13, 1100, Vienna, Austria., Arntz P; Department of Surgery, Amsterdam University Medical Centre Location AMC, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands., Bednarsch J; Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany., Abreu de Carvalho L; Department of HPB Surgery and Liver Transplantation, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium., Detry O; Department of Abdominal Surgery and Transplantation, CHU Liege, University of Liege, Avenue de l'Hôpital 1, 4000, Liège, Belgium., Erdmann J; Department of Surgery, Amsterdam University Medical Centre Location AMC, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands., Gruenberger T; Department of Surgery, HPB Centre Vienna Health Network, Clinic Favoriten, Wienerbergstraße 13, 1100, Vienna, Austria., Hermie L; Department of Vascular and Interventional Radiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium., Neumann U; Department of General, Visceral and Transplantation Surgery, Essen University Hospital, Hufelandstraße 55, 45147, Essen, Germany., Sandström P; Department of Surgery in Linköping and Biomedical and Clinical Sciences, Linköping University, Universitetssjukhuset, 581 85 Linköping, Sweden., Sutcliffe R; Department of Surgery, Queen Elizabeth Hospital Birmingham NHS, Mindelsohn Way, Birmingham, B15 2GW, United Kingdom., Denys A; Department of Radiology and Interventional Radiology, CHUV University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Melloul E; Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland., Dewulf M; Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands. Electronic address: maxime.dewulf@mumc.nl., van der Leij C; GROW - School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands., van Dam RM; Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands; GROW - School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands; Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany. Electronic address: r.van.dam@mumc.nl.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2024 Jul 16. Date of Electronic Publication: 2024 Jul 16.
DOI:	10.1016/j.hpb.2024.07.407
Abstrakt:	Background: Major hepatectomy in perihilar cholangiocarcinoma (pCCA) patients with a small future liver remnant (FLR) risks posthepatectomy liver failure (PHLF). This study examines combined portal and hepatic vein embolisation (PVE/HVE) to increase preoperative FLR volume and potentially decrease PHLF rates. Methods: In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry. The study included pCCA patients who underwent PVE/HVE between July 2016 and January 2023. Results: Following PVE/HVE, 28% of patients (9/32) experienced complications, with 22% (7/32) necessitating biliary interventions for cholangitis. The median degree of hypertrophy after a median of 16 days was 16% with a kinetic growth rate of 6.8% per week. 69% of patients (22/32) ultimately underwent surgical resection. Cholangitis after PVE/HVE was associated with unresectability. After resection, 55% of patients (12/22) experienced complications, of which 23% (5/22) were Clavien-Dindo grade III or higher. The 90-day mortality after resection was 0%. Conclusion: PVE/HVE quickly enhances the kinetic growth rate in pCCA patients. Cholangitis impairs chances on resection significantly. Resection after PVE/HVE is associated with low levels of 90-day mortality. The study highlights the potential of PVE/HVE in improving safety and outcomes in pCCA undergoing resection. Competing Interests: Conflicts of interest None to declare. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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